"First Event Back" Sponsorship Request Form
Kidney Donor Athletes
Personal Information
Full Name
First Name
Last Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Kidney Donation
-
Month
-
Day
Year
Date
Name of Athletic Event
Date of Athletic Event
-
Month
-
Day
Year
Date
What is the total cost of the fee for you to register for this event?
What is the total cost of the KDA gear you will be wearing in the event?
What is your personal performance goal for participating in this event?
Are you interested in fundraising for KDA as a part of your preparation for this event? *Note: if you answer 'no' to this question, you will still be considered for this scholarship!
Yes
No
Is this the first official athletic event you will be participating in since your kidney donation?
Yes
No
Are you willing to represent KDA by wearing gear provided to you, by sharing pictures from the event, and tagging KDA on your personal social media account(s)?
Yes
No
Submit Form
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